Hospital Beatriz Ângelo, Portugal.
Hospital Beatriz Ângelo, Portugal.
Foot Ankle Surg. 2022 Apr;28(3):319-323. doi: 10.1016/j.fas.2021.04.003. Epub 2021 Apr 15.
Associations of tendon injuries with ankle and hindfoot fractures is a current concern and recent research has linked specific fractures with specific tendon injuries, despite its functional impact being unknown. The purpose of this study is to assess that impact.
Computed tomography scans of patients with ankle and hindfoot fractures were reviewed for tendon injuries. Patients were clinically evaluated with the Visual Analogue Scale (VAS) and the Manchester-Oxford Foot Questionnaire (MOXFQ), via a telephonic interview.
Eighty-five patients were included in the study. The mean age was of 49.9 ± 16.5 (14-80) years and there were 43 females (50,6%). Mean follow-up was of 43,7 ± 15,1 (24,4-82,2) months. Tendon injuries were identified in 23 patients (27,1%) and the most common lesion was tendon entrapment. The tibialis posterior tendon (TP) was injured in 18 patients (21,2%) and comprised 58,1% of all tendon injuries. Tendon injuries were mostly associated with pilon fractures, which was the most common fracture type (44,7%). There was no clinical difference between patients with a tendon injury [VAS of 4,3 ± 2,6 (0-8) and MOXFQ score of 35,1 ± 22,4 (5-80)], and those without [VAS of 3,9 ± 2,5 (0-10) and MOXFQ of 34,3 ± 26,0 (0-95), respectively (p = 0,281 and 0,689)].
Tendon injuries were present in 27% of patients with ankle and hindfoot injuries. The most frequently injured tendon was the TP in association with pilon fractures, with entrapment being the most common lesion. These lesions, however, do not seem to reflect in a worse functional outcome at two years of follow-up.
跟腱损伤与踝关节和后足骨折的关联是目前关注的问题，尽管其功能影响尚不清楚，但最近的研究已经将特定的骨折与特定的跟腱损伤联系起来。本研究的目的是评估这种影响。
对踝关节和后足骨折患者的计算机断层扫描进行了跟腱损伤检查。通过电话访谈，对患者进行了视觉模拟量表（VAS）和曼彻斯特-牛津足部问卷（MOXFQ）的临床评估。
本研究共纳入 85 例患者。患者的平均年龄为 49.9 ± 16.5（14-80）岁，其中女性 43 例（50.6%）。平均随访时间为 43.7 ± 15.1（24.4-82.2）个月。23 例（27.1%）患者发现有跟腱损伤，最常见的病变是跟腱嵌压。18 例（21.2%）患者的胫骨后肌腱（TP）受伤，占所有跟腱损伤的 58.1%。跟腱损伤主要与 Pilon 骨折有关，后者是最常见的骨折类型（44.7%）。有跟腱损伤的患者（VAS 为 4.3 ± 2.6[0-8]，MOXFQ 评分为 35.1 ± 22.4[5-80]）与无跟腱损伤的患者（VAS 为 3.9 ± 2.5[0-10]，MOXFQ 评分为 34.3 ± 26.0[0-95]）之间在临床方面没有差异（p=0.281 和 0.689）。
踝关节和后足损伤患者中有 27%存在跟腱损伤。最常受伤的肌腱是 TP，与 Pilon 骨折有关，最常见的病变是嵌压。然而，在两年的随访中，这些病变似乎并没有导致功能结果更差。
